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Rhode Island rates for HCPCS 64495

Njx Dx/Ther Agt Pvrt Facet Jt Lmbr/Sac 3+ Level

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,333.99 / $1,518.41 / $3,955.04
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$1,783.12 / $1,783.12 / $1,783.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.10 / $84.30 / $129.01
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$137.69 / $137.69 / $137.69
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$164.86 / $381.52 / $616.55
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.64 / $95.06 / $140.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.64 / $108.34 / $177.39
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$540.00 / $1,401.00 / $4,915.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.48 / $128.78 / $206.59